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General NPI Number Information
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NPI Number | 1588749634
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Entity Type | Individual
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Provider Name | LAURA M WALBY MD
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 517 S SHARON AMITY RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-2975
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Country | US
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Telephone | 704-384-8800
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Fax | 704-384-8819
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 704-384-8800
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Fax | 704-384-8819
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | TRN7900
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 046401
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2015-01338
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME98701
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License Number State | FL
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